Adam Pavel, Sobek Ondrej, Táborský Ludek, Hildebrand Thomas, Tutterová Olga, Zácek Petr
Laboratory of Reference for CSF and Neuroimmunology, Department of Clinical Biochemistry, Immunology and Haematology, Homolka Hospital, Prague, Czech Republic.
Clin Chim Acta. 2003 Aug;334(1-2):107-10. doi: 10.1016/s0009-8981(03)00229-8.
To compare cerebrospinal fluid (CSF) and serum orosomucoid (alpha-1-acid glycoprotein-AAG) concentrations in various subgroups of patients with multiple sclerosis (MS).
CSF and serum AAG concentrations, AAG quotient (i.e., CSF AAG/serum AAGx10(3)) and index were determined in a group of 59 patients with clinically definite or probable MS. Patients were subdivided according to the disease form, disease severity according to an expanded disability status scale (EDSS), its treatment, disease duration and sex.
CSF AAG was increased in 52.5% of the patients and AAG quotient even in 64.4%. An increase in the CSF AAG concentration, as well as in AAG quotient and index, appear only after several years of disease duration, while no significant correlation with age has been found. This suggests that CSF AAG changes in MS represent a secondary, unspecific phenomenon and that this protein is not relevant for the aethiopathogenesis of the disease. Nevertheless, the finding of subnormal CSF AAG levels in some MS patients in remission (never observed in those in the attack) implies the possibility that CSF AAG may be used as a "state marker" in MS. Serum AAG levels were significantly lower in secondary progressive form and in severely disabled patients. This observation suggest that serum AAG values determination might have some prognostic significance. Further studies are, however, needed. Serum AAG should be investigated in parallel with other CSF and serum protein fractions in order to establish a pannel of examinations enabling multiple statistical analyses. This approach may lead to the finding of a "complex state marker" enabling thus to evaluate more precisely disease course in individual patients and to accept appropriate therapeutic measures.
比较多发性硬化症（MS）患者各亚组的脑脊液（CSF）和血清类黏蛋白（α-1-酸性糖蛋白-AAG）浓度。
测定了59例临床确诊或可能患有MS的患者的脑脊液和血清AAG浓度、AAG商（即脑脊液AAG/血清AAG×10³）和指数。患者根据疾病形式、根据扩展残疾状态量表（EDSS）评估的疾病严重程度、治疗情况、病程和性别进行细分。
52.5%的患者脑脊液AAG升高，64.4%的患者AAG商升高。脑脊液AAG浓度以及AAG商和指数仅在病程数年之后才出现升高，而未发现与年龄有显著相关性。这表明MS中脑脊液AAG的变化是一种继发性的非特异性现象，且该蛋白与疾病的发病机制无关。然而，在部分缓解期的MS患者中发现脑脊液AAG水平低于正常（发作期患者中从未观察到）意味着脑脊液AAG有可能用作MS的“状态标志物”。继发性进行性形式患者和重度残疾患者的血清AAG水平显著较低。这一观察结果表明血清AAG值的测定可能具有一定的预后意义。然而，还需要进一步研究。应将血清AAG与其他脑脊液和血清蛋白组分同时进行研究，以建立一套能够进行多种统计分析的检查项目。这种方法可能会发现一种“综合状态标志物”，从而能够更精确地评估个体患者的疾病进程并采取适当的治疗措施。
